Definition and Overview

Also known as septum surgery, septoplasty is the reshaping or repositioning of a deviated septum by adjusting the cartilages and bones in the nose.

The septum is the part of the nose that separates the two nostrils and is composed of bones and cartilages. For a number of reasons, the septum can become crooked or deviated, which means that one nostril is bigger than the other. Although this condition isn’t always serious, which means surgery may not likely be needed, more often, it can interfere with the flow of air in the nasal passage. It can also lead to other problems like pain and nasal bleeding.

Septoplasty, which is the only procedure that treats a deviated septum, should not be confused with rhinoplasty, which is also called a nose job. Although both procedures affect the nose, septoplasty doesn’t change the shape of the nose. Rhinoplasty is also cosmetic in nature while septoplasty is a reconstructive procedure, which means it may be covered by insurance.

Who Should Undergo and Expected Results

There are two general reasons why deviated septum develops: congenital and trauma. The congenital defect may be brought about by the way the foetus has developed or it could be that the baby is injured as it passes through the birth canal.

Traumatic injuries can also contribute to the development of a deviated septum, and the displacement of the septum may be sudden or gradual. It can be sudden if the impact is severe such as when a person falls flat on a concrete floor or gets involve in a vehicular accident. It can be gradual if the person is active in sports and the nose is repeatedly hit by a ball, for example.

Many cases of deviated septum are mild, and they don’t interfere with breathing. A doctor or an ENT specialist can confirm the condition through a simple test that uses a scope to assess the deeper tissues of the nose. A problematic septum is highly likely if the person experiences regular nasal bleeding with no other underlying condition or if he experiences pain in at least one side of the nose. Some factors such as age and nasal problems like rhinitis can exacerbate the condition.

By undergoing septum surgery, it’s expected that the patient will have a better air flow and breathe more efficiently. This can then significantly improve his mobility, endurance, and quality of life.

How Does the Procedure Work?

Before the septum surgery, which is performed by an ENT surgeon, the patient undergoes certain tests like X-rays, blood test, and physical examination to ensure that he is fit for the procedure. If he’s taking some medications especially blood thinners and aspirins, he may be requested to stop taking them for at least two weeks before the procedure to prevent excessive bleeding. The surgeon also plans for the procedure and will usually take nasal photos for comparison later.

The surgery can be performed either under local or general anaesthesia. Often, the latter is administered for maximum patient comfort. On an operating table, the patient lies face up with the nose exposed and the rest of the face covered. A small incision is then made on any side of the nose. Using a micro tool, the mucus membrane that covers the septum is lifted.

The surgeon then works on correcting the septum by reshaping or moving the bones and cartilage, as well as removing any excess bones or cartilage. The membrane is returned and repositioned, and the incision is closed. A splint is usually added to offer stability to the nose while it’s still healing. A packing material can also be placed on the nose to reduce bleeding. This can be removed within one or two days.

Septum surgery is often an outpatient procedure and takes between one to two hours to complete.

Possible Risks and Complications

Pain and discomfort as well as swelling are very common following a septoplasty, but these resolve on their own within 24 to 48 hours. Other possible risks and complications are bleeding and scarring. In very rare cases, the shape of the nose may appear changed. If certain nerves are damaged, the patient may experience an altered smelling capability.

Reference

  • Kridel RWH, Strum-O'Brien A. The nasal septum. In: Flint PW, Haughey BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA:Elsevier Mosby; 2015:chap 32.
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